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Barriers to life jacket use among adult recreational boaters
  1. D Alex Quistberg1,2,
  2. Linda Quan1,2,3,
  3. Beth E Ebel1,2,3,4,
  4. Elizabeth E Bennett3,
  5. Beth A Mueller1,4,5
  1. 1Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA
  2. 2Department of Pediatrics, University of Washington, Seattle, Washington, USA
  3. 3Seattle Children's Hospital, Seattle, Washington, USA
  4. 4Department of Epidemiology, University of Washington, Seattle, Washington, USA
  5. 5Fred Hutchison Cancer Research Center, Seattle, Washington, USA
  1. Correspondence to Dr D Alex Quistberg, Harborview Injury Prevention & Research Center, 325 Ninth Ave, Box 359960, Seattle, WA 98104–2499, USA; aquistbe{at}


Objective To identify barriers to life jacket use.

Design Cross-sectional survey.

Setting Nine public boat ramps in western Washington State, USA, August–November, 2008.

Participants 675 adult boaters (>18 years) on motor boats <26 feet long.

Main outcome Low or no life jacket use (0–50% of time) versus high life jacket use (51–100% of time).

Results Low/no life jacket use (0–50% of time) was associated with longer boat length (per foot, risk ratio [RR] 1.03, 95% CI 1.02 to 1.05), alcohol use (RR 1.11, 95% CI 1.01 to 1.20), perception of life jackets as ‘uncomfortable’ (RR 1.29, 95% CI 1.09 to 1.52), perceived greater level of swimming ability (RR 1.25, 95% CI 1.03 to 1.53 for ‘expert swimmer’) and possibly with lack of confidence that a life jacket may save one from drowning (RR 1.13, 95% CI 0.96 to 1.32). Low life jacket use was less likely when an inflatable life jacket was the primary life jacket used by a subject (RR 0.77, 95% CI 0.63 to 0.94), a child was onboard (RR 0.88, 95% CI 0.79 to 0.99) or if the respondent had taken a boating safety class (RR 0.94, 95% CI 0.87 to 1.01).

Conclusions Life jacket use may increase with more comfortable devices, such as inflatable life jackets, and with increased awareness of their efficacy in preventing drowning. Boater education classes may be associated with increased life jacket use among adults.

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